Professional Medical Education Research Articles

Characteristics of the status of professional identity of medical university residents

The relevance of the topic of the article is determined by the fact that the professional identity of the future doctor has a number of specific characteristics. These characteristics determine its uniqueness in comparison with other professional installations. The article considers the status of professional identity of first-year residents of a medical university. The status of professional identity is one of the criteria for the formation of the professional identity of a future doctor. The article describes the main characteristics of the identity status (premature identity, diffuse identity, moratorium, achieved identity, pseudo-identity). The article also discusses the socio-psychological conditions that contribute to the formation of a medical professional identity at the stage of training in clinical residency. Residency training is considered as the most important stage for the formation of professional identity. The residency training stage allows a young specialist to supplement theoretical knowledge in a narrower profile, consolidate practical skills and prepare for further independent professional activity. If we talk about the advantages of studying in residency, it can be noted that they are made up of the fact that they give a graduate of a medical university more knowledge, practical experience in clinical specialization and the possibility of its application in further professional activity. Clinical residency is a part of the higher education of medical professionals. At this stage, there is a more stable formation of the professional qualities of a doctor as an independent specialist.

Review on Medical Waste Management

Medical wastewater is analysed in this chapter, along with prevalent causes, governing legislation, and recycling and storage methods. Medical waste legislation exists in many developed countries, yet, there is no guideline on something that may and could be categorised as infectious. Selecting medical waste has grown inefficient leading to a shortage of clarity, culminating in a growth in the amount of garbage that may be cleansed for infections, which itself is usually done by incineration. According to this study it identifying garbage as hazardous leads to greater production of the waste. More investigation is necessary, given the tendency of increasing medical waste output with growing world GDP, and greater medical professional education and accessible medical generated waste sorting are significant possibilities for reduction and composting in healthcare institutions, according the paper.

Issues of reforming professional medical education in Russia

The reform of higher education is directly related to the solution of problems arising in the medical education system. The article describes the activities of the Section for the development of educational activities of therapeutic departments within the framework of the Russian Society for the Prevention of Noncommunicable Diseases, created to unite qualified teachers of medical education in solving problems of improving the efficiency of the process of training medical personnel in the specialty “Therapy”. The article discusses the organization of the project of the Russian Society for the Prevention of Noncommunicable Diseases on additional issues of the scientific and practical journal “Cardiovascular Therapy and Prevention. Professional education”, as well as the activities of the Section.

Prioritization of Factors that Determine Medical Practice Styles Using the Analytic Hierarchy Process

The medical profession has maintained its importance throughout human history. Communication between physician and patient is one of the most important issues that determine the success of the medical profession. In this success, physician behaviors and styles play a determining role in the practice of medicine. The aim of this study is to determine the factor weights affecting the practice styles in medicine and to prioritize them. The Analytic Hierarchy Process (AHP) is used in the study. The AHP technique is helpful for the decision maker as it prioritizes the factors based on their weights using a pairwise comparison matrix. The factor comparison data are obtained from a total of 22 clinician specialist physicians. According to the results of the application, the factors determining the practice style are Professional Experience (31.9%), Medical Education (21.8%), Patient and Disease (18.2%), Personality (11.5%), Institution (8.8%), and Family and Social Environment (7.8%), respectively. The concept of medical styles aimed to contribute to the development of the physicians’ own styles and to create awareness. It is expected to contribute to medical education and professional development.

17. Coaching and Medical Professionalism Education

17. Coaching and Medical Professionalism Education

16-1 Philosophical Dialogue and Medical Professionalism Education

16-1 Philosophical Dialogue and Medical Professionalism Education

Cinemeducation and Medical Professionalism Education Using Movies to Teach Medical Professionalism

Cinemeducation and Medical Professionalism Education Using Movies to Teach Medical Professionalism

Knowledge and Behavior in Rational Drug Use Among College Students in Zunyi City.

ObjectiveTo investigate the current status of knowledge and behavior about rational drug use in college students in different colleges and universities in a city in southwest China, providing reference for students’ education of rational drug use in colleges and universities.MethodsA questionnaire survey on knowledge and behavior in rational drug use was carried out on the students recruited by occasional sampling method in 6 colleges and universities in Zunyi, China. Statistical analyses on demographic information and answers to questionnaire questions were carried out with SPSS 18.0.ResultsA total of 865 valid questionnaires were recovered from 923 questionnaires sent out. Some knowledge and behaviors of the students on drug use were irrational. There was statistically significant difference in some specific questions of the knowledge in rational drug use between medical and non-medical students (P<0.05); the average score of rational drug use behavior of medical students was lower than that of non-medical students (P<0.05); the average score of the rational drug use behavior of female students was lower than that of male (P<0.05); the students’ major types had significantly different influence on their behavior in rational drug use (P<0.05). The school-carried pharmacy education can effectively improve students’ rational medication; the majority of college students believed that it is necessary to popularize the knowledge of rational drug use on campus; and students’ favorite way to acquire knowledge about rational drug use was to attend related lectures or elective courses.ConclusionThe knowledge and behavior of rational drug use among college students need to be improved. Professional medical education may exert a positive impact on rational drug use among college students. Thus, it is necessary to popularize the knowledge of rational drug use among college students, especially in non-medical colleges and universities.

17-1 Medical Professionalism Education through One-to-One Coaching

17-1 Medical Professionalism Education through One-to-One Coaching

17-2 Medical Professionalism Education through Team Coaching

17-2 Medical Professionalism Education through Team Coaching

THE POTENTIAL OF SITUATIONAL JUDGEMENT TEST AS AN INSTRUMENT OF ETHICAL COMPETENCE ASSESSMENT: A LITERATURE REVIEW

Background: Agreement on the importance of teaching and assessing ethical competence as part of professionalism in medical education continues to grow. The assessments of ethical competence at the “does” level in preclinical students or a large group of resident candidates are considered less efficient and expensive. It is necessary to find an alternative form of ethical competence assessment instrument as a complementary test at the level “knows how” before being tested at the level “does.” This research proposed investigating the Situational Judgement Test (SJT) potential and obtaining evidence of the SJT as an instrument of ethical competence assessment.Methods: This study was a literature review of 39 journal articles relating to SJT, obtained through PubMed data-based and google scholar search engine.Results: There was evidence of the use of SJT to assess ethical competence. Ethical competence can be evaluated by ethical decisions making ability. SJT containing procedural skills in ethical decisions making. SJT having good values as deliberation in ethical dilemmas and idealistic ethical ideology (conative test) also exists. These findings support the evidence of potential SJT to assess ethical competence.Conclusion: SJT can be used to assess ethical competence at the level “knows how” before being tested at the level “does” based on the following reasons: SJT can contain content questions that are conative, SJT can assess the ability of ethical decision making based on an assessment of procedural knowledge related to ethical deliberation of ethical decision making in ethical dilemmas.

Medical services in the context of the development of civil society

The article is devoted to the issue of aiming the activities of the healthcare system to meet the needs of society. The role of civil society institutions as consolidated customers of medical services is considered. The function of healthcare as a social institution responsible for the citizens’ well-being and health is described. The article focuses on the problem of introducing the practice and tools of public-state monitoring assessment into the healthcare organization system at the federal, regional, municipal levels and the levels of individual medical organizations. The article may be of interest to a wide range of readers, including employees of healthcare authorities, scientists and specialists in the field of philosophy, sociology, education, and law, medical workers, scientific and pedagogical workers of higher and secondary professional medical education, representatives of public organizations.

Comparative analysis of awareness of medical professionals in three Balkan countries (Bulgaria, Croatia, and Slovenia) of continuing education of medical professionals in the area of pharmaceutical policy in the respective countries.

The objectives of our study were to establish the extent to which medical professionals are willing to upgrade their skills, to find out whether they have to resort often in their daily work to the support of colleagues in matters related to pharmaceutical policy, and to find out if they attend any forms of continuing education and whether such forms are available at their workplaces. The study also aimed to establish what web-based forms of continuous education the graduated medical professionals in Bulgaria, Croatia, and Slovenia know and consider to be up-to-date and adequate to their needs for specialised training programmes which ensure that their knowledge will be adequate to the constantly evolving environment in the area of pharmaceutical policy and pharmaceutical regulation. A survey was carried out among a representative sample drawn from three Balkan countries: Bulgaria, Croatia, and Slovenia. The survey was based on voluntary participation and relied on the 'snowballing' technique in order to recruit respondents and disseminate questionnaires. The results from the study demonstrate that the respondents are willing to, and are aware that they should, join forms of continuing education in the area of pharmaceutical policy since some of them encounter certain challenges related to the level of their knowledge in this domain, and that the deployment of specialised online programmes and other activities (such as workshops, conferences, etc.) for professional qualification of employees will certainly contribute to the enhancement of their qualification and to the improvement of the health services provided to citizens. To keep in pace with modern trends in the area of postgraduate education, the medical universities which are most trusted by the respondents from the three countries included in survey as well as the career development services providers which offer postgraduate training courses should focus on the development and implementation of innovative forms of web-based postgraduate/upskilling education in the area of pharmaceutical policy to ensure that more potential learners can join and update their understanding of this dynamic and rapidly evolving area of scientific knowledge.

A Meaningful and Actionable Professionalism Assessment: Validity Evidence for the Professionalism Mini-Evaluation Exercise (P-MEX) Across 8 Years.

With the growing importance of professionalism in medical education, it is imperative to develop professionalism assessments that demonstrate robust validity evidence. The Professionalism Mini-Evaluation Exercise (P-MEX) is an assessment that has demonstrated validity evidence in the authentic clinical setting. Identifying the factorial structure of professionalism assessments determines professionalism constructs that can be used to provide diagnostic and actionable feedback. This study examines validity evidence for the P-MEX, a focused and standardized assessment of professionalism, in a simulated patient setting. The P-MEX was administered to 275 pediatric residency applicants as part of a 3-station standardized patient encounter, pooling data over an 8-year period (2012 to 2019 residency admission years). Reliability and construct validity for the P-MEX were evaluated using Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Cronbach's alpha for the P-MEX was 0.91. The EFA yielded 4 factors: doctor-patient relationship skills, interprofessional skills, professional demeanor, and reflective skills. The CFA demonstrated good model fit with a root-mean-square error of approximation of .058 and a comparative fit index of .92, confirming the reproducibility of the 4-factor structure of professionalism. The P-MEX demonstrates construct validity as an assessment of professionalism, with 4 underlying subdomains in doctor-patient relationship skills, interprofessional skills, professional demeanor, and reflective skills. These results yield new confidence in providing diagnostic and actionable subscores within the P-MEX assessment. Educators may wish to integrate the P-MEX assessment into their professionalism curricula.

Dual and duelling purposes: An exploration of educators' perspectives on the use of reflective writing to remediate professionalism in residency.

CONTEXTProfessionalism lapses have high stakes for learners and educators. Problems with professionalism, unless appropriately and effectively remediated, may portend serious problems in practice. Yet, remediation for unprofessional behaviour is particularly challenging—and understudied. Increasingly, educators are turning to reflective writing as a remediation strategy in residency, yet little is known about what educators expect reflective writing to accomplish, how they choose reflective writing tasks, why they use reflective writing, or how they evaluate whether a learner has met expectations. We aimed to understand why and how postgraduate medical educators use reflective writing as an educational intervention to remediate professionalism.METHODIn this constructivist grounded theory study, we interviewed 13 medical education professionals with experience using reflective writing to remediate professionalism across five Canadian medical schools. Data collection and analysis occurred iteratively using constant comparison to identify themes and to understand the relationships among them.RESULTSMedical educators reported using reflective writing as a learning tool to develop insight and as an assessment tool to unearth evidence of insight. The goal of learning may compete with the goal of assessment, creating tension that leads to uncertainty about the sincerity, quality and effectiveness of reflective writing as well as concerns about learner safety. Educators reported uncertainty about whether learners write to pass or to introspect and about how to judge the effectiveness of reflective writing as a learning tool. They expressed concern about creating a safe environment for learners—one that enables the genuine reflection required for insight development—while meeting requirements of remediation.CONCLUSIONSEducators express ambivalence about using reflective writing to remediate professionalism in residency. Understanding the potential and pitfalls of reflective writing may inform more tailored and effective approaches to remediate professionalism.

Epidemiology, Etiology, and Treatment of Gastroparesis: Real-World Evidence From a Large US National Claims Database

Although gastroparesis carries a considerable health care and patient burden, associated epidemiological data are limited. To provide new real-world evidence for gastroparesis, we estimated disease prevalence, and investigated patient demographics and disease etiology in a large US claims database. This retrospective, cross-sectional analysis used de-identified, longitudinal patient-level enrollment and billing data for adults from the Optum Clinformatics Data Mart database, a large US national administrative health insurance claims database. Prevalence was age-, sex-, and geographical region-standardized using the 2018 US census. Descriptive analyses of demographic and clinical variables and underlying disease etiologies were performed. The overall standardized prevalence of gastroparesis was 267.7 (95% confidence interval [CI] 264.8-270.7) per 100,000 US adults, whereas prevalence of "definite" gastroparesis (individuals diagnosed within 3 months of gastric emptying scintigraphy testing with persistent symptoms for more than 3 months) was 21.5 (95% CI 20.6-22.4) per 100,000 persons. Patients with gastroparesis had an overall Charlson Comorbidity Index score of 4.2, indicating substantial comorbidity burden. The most frequently documented comorbidities were chronic pulmonary disease (46.4%), diabetes with chronic complication (37.3%), and peripheral vascular disease (30.4%). Patients most commonly had a diabetic etiology (57.4%; type 1, 5.7% and type 2, 51.7%), followed by postsurgical (15.0%), drug-induced (11.8%), and idiopathic (11.3%) etiologies. New evidence is provided regarding the prevalence, patient demographics, and etiology of gastroparesis in the US general population. Wider availability of reliable objective gastric emptying measures and further education of medical professionals in recognizing and diagnosing gastroparesis would benefit future studies and improve understanding of disease epidemiology.

AI for Doctors-A Course to Educate Medical Professionals in Artificial Intelligence for Medical Imaging.

Successful adoption of artificial intelligence (AI) in medical imaging requires medical professionals to understand underlying principles and techniques. However, educational offerings tailored to the need of medical professionals are scarce. To fill this gap, we created the course “AI for Doctors: Medical Imaging”. An analysis of participants’ opinions on AI and self-perceived skills rated on a five-point Likert scale was conducted before and after the course. The participants’ attitude towards AI in medical imaging was very optimistic before and after the course. However, deeper knowledge of AI and the process for validating and deploying it resulted in significantly less overoptimism with respect to perceivable patient benefits through AI (p = 0.020). Self-assessed skill ratings significantly improved after the course, and the appreciation of the course content was very positive. However, we observed a substantial drop-out rate, mostly attributed to the lack of time of medical professionals. There is a high demand for educational offerings regarding AI in medical imaging among medical professionals, and better education may lead to a more realistic appreciation of clinical adoption. However, time constraints imposed by a busy clinical schedule need to be taken into account for successful education of medical professionals.

The Content Quality of YouTube Videos for Professional Medical Education: A Systematic Review.

To evaluate the content quality of YouTube videos intended for professional medical education based on quality rating tool (QRT) scores and determine if video characteristics, engagement metrics, or author type are associated with quality. The authors searched 7 databases for English-language studies about the quality of YouTube videos intended for professional medical education from each database's inception through April 2019. To be included, studies had to be published in 2005 (when YouTube was created) or later. Studies were classified according to the type of QRT used: externally validated, internally validated, or limited global. Study information and video characteristics and engagement metrics were extracted. Videos were classified by video author type. Thirty-one studies were included in this review. Three studies used externally validated QRTs, 20 used internally validated QRTs, and 13 used limited global QRTs. Studies using externally validated QRTs had average scores/total possible scores of 1.3/4, 26/80, and 1.7/5. Among the 18 studies using internally validated QRTs, from which an average percentage of total possible QRT score could be computed or extracted, the average score was 44% (range: 9%-71%). Videos with academic-physician authors had higher internally validated QRT mean scores (46%) than those with nonacademic-physician or other authors (26%; P < .05). The authors found a wide variation in QRT scores of videos, with many low QRT scores. While videos authored by academic-physicians were of higher quality on average, their quality still varied significantly. Video characteristics and engagement metrics were found to be unreliable surrogate measures of video quality. A lack of unifying grading criteria for video content quality, poor search algorithm optimization, and insufficient peer review or controls on submitted videos likely contributed to the overall poor quality of YouTube videos that could be used for professional medical education.

Network partnership in the implementation of additional professional medical education programs

In this article, in the format of a review, general and applied issues of network partnership in the implementation of programs of additional professional medical education are considered, the experience of cooperation is presented and the main approaches to ensuring the quality of AVE programs are presented.

Factors influencing upward referral system of patients in Nairobi County

Background: The referral system forms main health systems coordinating a mechanism ensuring the harmonious movement of patients between different levels of health care institutions for effective and efficient service delivery. The study aimed at establishing the determinants of upward referral system of patients in Nairobi County. Methods: Cross-Sectional data collected from 204 respondents from 2May to 30June, 2021, through a structured questionnaire from level 3-5 public facilities in Nairobi County was used. Data was analyzed using SPSS. Doctors, nurses and clinical officers who have referred patients in the previous three months were included while those who had not were excluded.Results: Bivariate analysis results revealed that knowledge of referral system (r=179*, p=0.011) and complexity of patient disease (r=097, p=0.170) had positive and significant correlation with upward referral system. Multivariate analysis results showed that proximity to the referral health facility had positive and statistical significant (β4=0.640, p&lt;0.002) to upward referral system.Conclusions: The results revealed that although healthcare workers know about the referral strategy, they lack full comprehension of the referral strategy. Patients are mostly referred when higher diagnostic equipment are needed and when the medical conditions are dire. The study recommends professional medical education to equip the human resources for health with the requisite knowledge on the referral system and establishment of effective communication systems between the lower levels health facilities and the higher or specialized facilities to ensure there a smooth referral system in Nairobi County.